Individual provider Active NPI

Amy Ann Marie Esposito, RD

  • Registered Dietitian
  • San Pedro, CA
National Provider Identifier
1265100747
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1081744 Issued in CA
Practice address
1110 W 10TH St Apt 207
San Pedro, CA 90731-3401
Phone
(310) 736-8755
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1081744 CA Primary

Addresses

Primary practice location

1110 W 10TH St Apt 207
San Pedro, CA 90731-3401

Mailing address

1110 W 10TH St Apt 207
San Pedro, CA 90731-3401
Phone (310) 736-8755

Other identifiers 1

IdentifierTypeStateIssuer
NAMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1081744CAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1265100747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W 10TH ST APT 207",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313401",
            "telephone_number": "310-736-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W 10TH ST APT 207",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313401",
            "telephone_number": "310-736-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "AMY",
        "middle_name": "ANN MARIE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1081744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.